How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2.00 Median $2.24 Typical High $2.95 | Facility | None | $2.00 | $2.24 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
BCBS Arizona Setting Facility Modifier None Typical Low $1.12 Median $4.68 Typical High $7.59 | Facility | None | $1.12 | $4.68 | $7.59 |
BCBS Arizona Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $9.33 | Professional | None | $1.35 | $1.35 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $2.19 Typical High $2.34 | Facility | None | $1.55 | $2.19 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Medica Setting Facility Modifier None Typical Low $0.41 Median $1.35 Typical High $1.78 | Facility | None | $0.41 | $1.35 | $1.78 |
Medica Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | 52 · Reduced service | $0.69 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Where Arizona sits
The same service costs 1.7 times more in Arizona than in Oklahoma. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arizona· 1st of 51
$2.14
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.